“As an institution, our quest is to continue to innovate new ways for improving the care we deliver to each patient we serve,” says Kevin W. Sowers, chief operating officer and interim CEO.

Duke’s leadership team supports structured performance improvement strategies and a balanced set of indicators of success focused on four major priorities: clinical quality, customers, work culture and finance.
“When you have employees with the best concern for our patients at heart — employees who understand the need for a balanced view of success — it doesn’t go unrecognized,” Sowers says.

U.S. News & World Report ranking
For the 19th year in a row, Duke University Hospital has been named one of the top 10 U.S. hospitals by U.S. News & World Report. Ranked at No. 8, the hospital system also was listed high in 15 of the specialties measured, with top 10 rankings in seven categories.

Duke ranked fourth in gynecology, fifth in geriatrics, sixth in urology, seventh in orthopaedics, eighth in heart surgery and ophthalmology, ninth in respiratory and pulmonary disease, 11th in cancer care, 12th in kidney disease and psychiatry, 14th in rheumatology, 15th in gastroenterology, 20th in otolaryngology and neurology/neurosurgery, and 21st in endocrinology.

“Duke’s consistent high rankings among the top 10 best hospitals in the nation is a testament to the excellent quality of patient care, the dedication of our employees, nurses and doctors, and to the innovation of our medical center,” says Dr. Victor Dzau, chancellor of health affairs for Duke University in Durham and president and CEO of Duke University Health System.

“We are proud to be included in this group of great U.S. medical institutions.”

The Duke University School of Medicine also recently was named one of the top 10 schools of medicine in its annual America’s Best Graduate Schools edition.

Duke Children’s Hospital
Earlier this year, Duke Children’s Hospital opened North Carolina’s only dedicated pediatric cardiac intensive care unit (PICU). The 6,200 square-foot, 13-bed unit is staffed by 23 physicians, 75 nurses, respiratory therapists, social workers, pharmacists, and other caregivers with experience and a special interest in critical care for pediatric patients with heart disease. It allows more families to seek cardiac care at Duke Children’s and frees up space for other critical care needs in the existing PICU.

“One of the most important periods in critical care is the hands-off period when the patient leaves the operating room and enters the intensive care unit. It’s a time when patients can quickly become unstable,” says Dr. Jon Meliones, unit director.

“We borrowed from military and aviation models in designing a communications system that calls for regular reporting procedures for every step of the way, and the protocol begins when the patient enters the operating room, not when he or she leaves.”

The advancement is further evidence of Duke Children’s dedication to providing the best possible care for patients and families, and comes on the heels of its ranking among the best children’s hospitals in the country by U.S. News & World Report.

“We are committed to achieving and maintaining a standard of excellence in all we do,” says Dr. Joseph St. Geme, chair of Duke’s department of pediatrics and chief medical officer of Duke Children’s Hospital.

“Most important, we consistently strive to make the patient experience a model of quality care through advanced treatment, compassionate support, and full family participation and communication,” St. Geme adds. “We also set the highest standard possible for training pediatric health care professionals by offering innovative curricula and educational systems to enhance the learning and development of trainees.”

Nursing excellence
In 2006, Duke University Hospital achieved magnet status for nursing excellence from the American Nurses Credentialing Center, the credentialing arm of the American Nurses Association. The designation followed a rigorous, three-year application and evaluation process that included interviews with more than 500 nurses, physicians, and staff, as well as examination of almost 3,000 pages of documentation.

“The ranking is a result of a national survey that was conducted of nurses across the country,” says Mary Ann Fuchs, MSN, RN, chief nursing and patient care services officer.

“Nurses consistently ranked Duke as a leader in fostering the ongoing education and professional development of the nursing staff.”

Fuchs adds that all three Duke hospitals have achieved the designation.

“This is an accomplishment that very few health systems across the country attain,” she notes. “We believe that we have opportunities for a lifetime for nurses to practice within Duke Medicine.”

Duke University Medical Center also was named among the Top 100 Hospitals to Work For list for 2009 by Nursing Professionals. The hospital earned a spot at No. 15 based on job satisfaction.

Patient-centered medical home
Duke University Medical Center’s Division of Family Medicine is one of the first practices in the Southeast to be recognized by the National Committee for Quality Assurance (NCQA) for operating a patient-centered medical home.

The concept of a medical home, which has garnered attention recently as a potential model for the future of the national health care system, came about several years ago. This new model for care focuses on patient needs through use of a health care team responsible for helping patients navigate all aspects of their health.

“We recognized the need for a fundamental shift in the way we provided care that focused on comprehensive treatment for our patients, not just their acute situations,” says Dr. Lloyd Michener, chairman of Duke’s department of community and family medicine.

“We asked patients what they needed, began tracking feedback and embraced new technology to improve our ability to provide quality, efficient care.”

The designation is presented to medical facilities that meet a rigorous and comprehensive set of standards for primary medical care.

“This recognition provides external validation that we are a cutting-edge family medicine practice,” says Dr. Samuel Warburton, chief of Duke’s division of family medicine.

America’s Top Doctors for Women
Four Duke physicians were named America’s Top Doctors for Women in the November 2008 issue of Women’s Health magazine: Dr. Diana Dell, assistant professor of psychiatry and behavioral sciences; Dr. Mark Feinglos, professor of medicine and chief of Duke’s division of endocrinology, metabolism and nutrition; Dr. David Walmer, associate professor of obstetrics and gynecology and chief of the hospital system’s division of reproductive endocrinology and fertility; and Dr. Richard Weisler, adjunct associate professor of psychiatry and behavioral sciences.

The honorees were selected from the 10 specialties most essential to women’s health, as designated by the magazine and research firm Castle Connolly. Duke had the second-highest number of physicians in the South division, which included 27 health care systems.

“The rankings affirm that our staff is among the most well-respected in the nation,” Sowers says.

Duke Medical Plaza in Morrisville
The 20,000-square-foot Morrisville clinic, which opened late last year, offers primary care, specialty care, and urgent care services. The clinic is on Chapel Hill Road, just minutes from Raleigh-Durham International Airport.

Duke Urgent Care Morrisville is open from 8 a.m. to 8 p.m. every day, while Duke Primary Care and Duke Medicine are open from 8 a.m. to 5 p.m. Monday through Friday. Cardiology and orthopedic specialty care will be coming soon. The idea is to offer several services under one roof in a convenient location.

“Duke Medical Plaza in Morrisville provides much-needed services in a community where there are few medical facilities to meet the continued needs of this growing population,” says Pamela Sutton-Wallace, associate vice president of ambulatory care services for Duke University Health System.

CCU room redesign
What once was a unit with patient beds separated only by curtains at Durham Regional Hospital has become a 22-bed critical care unit (CCU) with all private rooms. Each patient room now is equipped with the latest technology.

Rooms are dialysis-ready and contain a Stryker InTouch Smart Bed, which can talk to patients in three languages, calculates weight, wheels itself while steered by a caregiver and includes an alarm that alerts the care team when a patient needs to be turned; a moveable utility pole that can move to the patient to better accommodate suction and blood pressure readings; and a flat-screen television.

Computers on wheels are used to enable nurses to have a patient’s medical information at their fingertips. Nurses also can take notes on patients while they’re in the room, leaving less room
for error.

“We are thrilled with the design of our unit,” says Earl Dalton, RN, unit director.

“In redesigning it, we wanted to bring the care to the patient, not the patient to the care.”

Duke’s nurses were involved in every stage of the planning process, providing input on the overall layout and type of equipment selected. The $8.6 million renovation was funded by Duke University Health System and the Durham County Hospital Corporation Board.

National Medal of Science
Dr. Robert J. Lefkowitz, a Howard Hughes Medical Institute investigator at Duke University Medical Center, received the National Medal of Science last fall for his contributions to the biological sciences.

Lefkowitz, a Duke faculty member since 1973, calls the country’s highest honor for science “a great personal and professional honor.”

The seven transmembrane receptors he discovered — which are located on the surface of the membranes surrounding cells and have been deemed the largest, most versatile and most therapeutically accessible reception signing systems — are the targets of almost half of the drugs on the market today, including antihistamines, ulcer medications, and beta blockers for heart disease.

He and his group first identified, purified, and cloned the genes for these receptors during the 1970s and 1980s, thus revealing the structure of the receptors as well their functions and regulation. This work facilitated and fundamentally altered the way in which numerous therapeutic agents have been developed.

Lefkowitz has received more than 50 international and national awards, earned several honorary doctorate of science degrees, and has held leadership posts in many clinical and professional organizations. In 2007, he received the Shaw Prize in Life Science and Medicine for his breakthrough research and the Albany Medical Center Prize in Medicine and Biomedical Research.

Hospice Center
The Hock Family Pavilion on North Roxboro Road in Durham is Duke HomeCare & Hospice’s new hospice facility, featuring 12 private patient rooms, 24-hour skilled nursing care and an interdisciplinary team of nurses, social workers, chaplains, nursing assistants, bereavement counselors, and volunteers. The center expands the hospital system’s services beyond what was available through its six-bed facility in Hillsborough.

Hospice care addresses the physical, emotional, and spiritual needs of patients and their loved ones. Last year, Duke Hospice served the needs of 900 patients and their families. A majority of hospice care was provided in patients’ homes, but more than 260 people received care at Duke Hospice at the Meadowlands last year.

“It’s for the patient, but for the family as well,” says Starr Browning, executive director of Duke HomeCare & Hospice.

“It’s about meeting the needs of individuals in their final days.”

Mary Ann Fuchs, MSN, RN

Mary Ann Fuchs never dreamed that she’d be the head nurse at a world-renowned hospital system. But she’s successfully held the position for the past decade, and she wouldn’t change it for anything.

Fuchs, chief nursing and patient care services officer, came to Duke 26 years ago as a new graduate. Over time, she grew into various leadership roles, including nurse manager, director of oncology services and associate chief operating officer for oncology services. During this time, she was able to attain a master’s degree in nursing and a post-master’s certificate in education. She’s currently a student in the Doctor of Nursing Practice program at the Duke University School of Nursing.

“I have always found that Duke offers so many opportunities to grow and develop,” she says.

A Johnson & Johnson Wharton Fellow, Robert Wood Johnson Executive Nurse Fellow and recipient of the North Carolina Great 100 Nurses award, Fuchs also is the elected health system administrator for the North Carolina Board of Nursing.

With so many projects and initiatives at Duke, she has the delicate task of balancing the hospital system’s three missions: patient care, education and research.

“But I’m a person who likes to be challenged and busy, so these are welcomed challenges,” she says.

Dr. Tracey Gaudet

As executive director of Duke Integrative Medicine and assistant professor of obstetrics and gynecology at Duke University, Dr. Tracey Gaudet continually works to help people change their lives.

While in residency at the University of Texas in San Antonio, she received a newsletter that described Dr. Andrew Weil’s vision for a new program in integrative medicine at the University of Arizona.

“It described things like whole-person care and other aspects of what I always thought health care should be about and that I was passionate about,” she says.

Gaudet — a Duke undergraduate and graduate student — quickly joined, becoming the first medical director of Weil’s program.

“Our work was focused on more than teaching doctors about how treatments like acupuncture and massage, hypnosis and nutrition, and meditation and yoga can complement the conventional treatments we learn about in medical school,” she says.

“We were working then — and are working now — on shifting the culture of medical practice so that it’s patient-centered rather than doctor-directed.”

Because of her work, Gaudet was approached to create Duke Integrative Medicine to design innovative models of health care that address the whole person.

“I’ve always had a great deal of respect for Duke as an innovative and entrepreneurial academic center,” she says.

“This has been such a wonderful opportunity.”

Dr. Magnus E. Ohman

In 2001 — after training in Ireland and at Duke — Dr. Magnus E. Ohman was asked to head up the UNC Heart Center in Chapel Hill. When the nearby Duke Heart Center began exploring novel care strategies in 2005, it seemed only natural for him to return to his roots.

As associate director of the Duke Heart Center, Ohman oversees its outpatient practice. He’s also director of its program for advanced coronary artery disease, which helps patients with complex heart disease get better care and find treatment options.

“The center has the ability to take the latest and most advanced technologies and apply them to improve patient care,” he says.

“We use a team approach with multiple specialists to develop a treatment strategy for each individual patient to enable the best outcomes.”

When he was a child, Ohman suffered from recurrent tonsil infections that required countless visits to the doctor. These experiences helped shape his future in medicine.

“I started to recognize the tremendous impact health care providers had on my life, and it seemed natural for me to work in a field where you can do so much to help patients get to a better place,” he says.

“Now, I’m fortunate to work with some of the brightest scientists at the Duke Clinical Research Institute in developing research that will transform care not only in North Carolina but also the rest of the world.”

Dr. Lisa Pickett

After serving for several years at both Durham Regional Hospital and Duke University Medical Center, Dr. Lisa Pickett recently took on the role of chief medical officer.

“There is a tremendous benefit to both institutions in this partnership, and we can gain the most from this with excellent communication,” she says.

“I hope to be able to enhance this relationship and facilitate patient, information, and program flow across the health system.”

Pickett — who’s also an assistant professor of surgery and medicine at Duke University and an intensivist and co-director of Durham Regional Hospital’s critical care unit — says she’s humbled by the access patients offer into their families and their lives.

“My job is most rewarding when a patient comes back to my office in street clothes, smiling,” she says.
Pickett has had an opportunity to train across many levels at Duke, from surgery to critical care. Through her role as division chief at Durham Regional Hospital’s Division of General Surgery, she was able to help grow its intensivist program.

“This has been a true partnership between Durham Regional Hospital and Duke, and it highlights the benefits to both institutions working together,” she says.

Dr. Victoria Seewaldt

When her best friend’s mother died of breast cancer, Dr. Victoria Seewaldt — then 11 — had no idea the profound effect it would have on her life.

“She was the first person I heard speak the words ‘breast cancer,’ ” she says. “Her beauty and bravery stuck with me.”

Seewaldt, who has done extensive work with world-renowned doctors who encouraged her to follow her dreams, founded and now leads the Breast Wellness Prevention Clinic at the Duke Comprehensive Cancer Center in Durham. She was able to launch the clinic through an initial grant from The V Foundation for Cancer Research, and since has secured funding from the Susan G. Komen and Avon foundations to improve early detection and prevention.

At the clinic, Seewaldt and her staff work to identify precancerous changes in the breast, eliminate those changes if possible, and provide the best imaging possible to provide early detection.

“Our goal is to bring the best of Duke research to the bedside and use research to provide early detection and prevention of breast cancer,” she says.

“Women’s health care is a partnership, and this partnership comes naturally to me,” Seewaldt adds. “I feel that Durham is a place where a lot of good can happen, and I want to be part of this change.”